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Safety and efficacy of retrograde intrarenal surgery in pediatric stone disease

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Bülent Altay, Bülent Erkurt, Fırat Erdoğan, Cem Cahit Barışık, Vahit Güzelburç and Selami Albayrak

Objectives: To evaluate the safety and efficacy of flexible ureteroscopic (FURS) lithotripsy for intrarenal stones in children younger than 12 years.

Methods: From January 2004 to March 2013, 44 patients (29 males and 15 females) with a mean age of 5.8 ± 1.6 years (range 0.5 to 12) underwent flexible ureteroscopic laser lithotripsy for the treatment of kidney stones. The baseline characteristics, findings of metabolic assessement, perioperative data and complications were recorded. Evaluation of outcomes were assessed at 2, 12 and 24 weeks postoperatively with urine analysis and ultrasonography.

Results: Mean age was 5.8 ± 1.6 (range 0.5 to 12). Mean stone size was 12 ± 2.1 mm (range 8 to 25). The overall stone-free rate after a single procedure was found 84% at 2 week and 93.1% at 3 month. A secondary treatment (SWL, PNL or re-FURS) was not required in any patients. Failure of initial ureteral access (6.8%), urinary tract infection (13.6%), acute pyelonephritis (2.2%), hematuria (2.2%) and acute urinary retention early postoperatively (6.8%) were recorded as surgery related specific complications.

Conclusions: FURS seems to be a safe and effective procedure and could play an important role in the management of pediatric kidney stones.

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